The Sore Truth of a Sore Throat
What Types of STDs Cause Sore Throat?

The Sore Truth of a Sore Throat

The world is overrun by various diseases that most often than not mimic each other presentations – leading to a wide array of misdiagnoses, particularly in cases where patients attempt to self-diagnose their condition in fear that they would either not be getting the proper treatment that they need, or that the visit to the doctor is just an easy way to lose a few dollars when they could supposedly “address” their symptoms on their own with just a quick internet search.

Sure enough, this could not be more wrong in several aspects, and it is highly discouraged to address your symptoms with medications, especially when it comes to more systemic conditions, those that could not be explained with your history, and those that seem to be indicative of a wide array of overlapping conditions. While this fact may be evident for certain diseases all over the body, this is observed more in sexual health cases – mainly due to the stigma surrounding this entire issue.

Sore throat is a symptom that most people would commonly disregard due to this presentation's perceived “mundaneness.” However, you should likewise realize that even though the area is relatively apart from most of your sexual organs, sexually transmitted conditions may, in fact, affect other parts of the body, especially those that are covered in mucosal membranes that serve as the entry point for most pathogens. With such a perspective on this manifestation, one should remember that brushing off even something as simple as a sore throat may lead to more complicated repercussions in the long run – especially when you are sexually active and are at a higher risk for contracting STDs/STIs.

To avoid such a mundane symptom from developing into a full-blown irreversible complication, perhaps it is more efficient to look deeper into the common origin of sore throat presentations – distinguishing them from the manifestations to provide a rough differential deduction of the potential tests that you could undergo in properly “managing” the condition underneath.

Sore Throats – An Overview

A sore throat can be described by many as a sensation that is akin to pain, scratchiness, or irritation along the pharyngeal area, commonly worsening when eating or swallowing. It is a condition that is often brushed off by many as a symptom that results from either stressing out over one too many late-night shifts or overeating ice cream when it actually commonly is from an underlying infection within the area. Sore throats caused by viral infections are often self-limiting and resolve on their own. Still, likewise, other underlying conditions may result in its eventual progression into a more severe disease, mainly if it is caused by an aggressive condition affecting another part of the body that happened to produce effects within the pharyngeal area.

Severe Signs and Symptoms Associated with Sore Throat

Apart from the previously mentioned signs and symptoms associated with sore throat presentations, it might be imperative for you to immediately seek out the advice of a professional when the following manifestations are now evident along with the previously discussed symptoms:

  • Breathing difficulties
  • Swallowing difficulties
  • Excessive drooling due to one’s inability to swallow
  • Lasted for more than a week
  • Severe pain
  • Joint pain
  • Pain in the ear
  • Spreading rash
  • High fever (> 38.3C)
  • Blood in phlegm or saliva
  • Swollen lymph nodes

Who are at a Higher Risk for this Manifestation?

Much like in any other condition, specific populations are more susceptible to contracting sore throats and the common underlying conditions behind it due to the predisposing factors that they might have for these particular instances.

Children and Teenagers

Studies have found that children ages 3 to 15 are at a higher risk for developing sore throats and are likewise more likely to develop a condition known as strep throat.

Smokers

Smoking can continuously irritate the throat, and tobacco products have increased the risk for mouth, throat, and laryngeal cancer.

Seasonal Allergies

Allergic reactions to dust, mold, or pet dander could irritate the throat and increase the risk of developing a sore throat.

Recurring Sinus Infections

Sinus infections commonly cause postnasal drips or drainage, which may introduce pathogens into the esophageal area – resulting in more frequent sore throats.

Living in Close Quarters

Considering the proximity, it is easier to transmit bacterial and viral infections among different individuals – leading to increased susceptibility in contracting the pathogens that cause sore throat.

Immunocompromised

Much like in any other instance, immunocompromised people have difficulties preventing attacks from foreign pathogens – making it far easier for them to contract sore throats and other underlying conditions.

Preventing Sore Throats

In addressing the manifestation, it might likewise be efficient to be wary of how one can prevent its recurrence following the first instance.

Regular Handwashing

This can be performed for at least 20 seconds to ensure that you will not be carrying various pathogens around with you – preventing potential infections throughout the process.

Avoid Touching your Face

This commonly includes avoiding touching your face, mouth, and nose, as these cavities serve as entry points for pathogenic microorganisms.

Avoid Sharing Food and Utensils

In cases where you are not particularly sure whether another individual is not carrying a particular condition, it might be wise to avoid sharing objects used to enter your mouths, such as utensils and food. While this might seem like a preventive measure that could be done on a case-to-case basis, being sure of your safety is much better than being at risk of developing a particular infection.

Hygienic Disposal of Waste

Do not carry around towels and tissues that you have sneezed on to avoid the microorganisms from spreading. Upon use, immediately throw it away and wash your hands thoroughly.

Using Sanitizers

Alcohol-based sanitizers are incredibly effective in ensuring that your hands are adequately disinfected, especially in cases where there is no access to running water or soap.

Disinfecting Belongings

Considering how easy it is for microorganisms to transfer from object to object, disinfecting your belongings is a great way to ensure that you will not be picking up pathogens from the things you commonly use (phones, doorknobs, keyboard, remote).

Avoiding Contact with Communal Properties

To avoid contracting conditions from communal properties such as water fountains and public phones, you could either first disinfect the areas you are touching or completely avoid using them altogether.

Potential Causes for Sore Throats you Might Want to Initially Rule Out

To provide you with a more detailed list of differential diagnoses that you could rule out in determining whether your sore throat is being caused by a sexually transmitted condition or one that is just as severe on its own entirely, knowing the manifestations and telltale signs of other diseases is the easiest way to distinguish the two categories.

Viral Infections

Viral conditions are widely prevalent in the public due to how easy it is to contract the pathogen causing a particular condition. The following conditions are examples of viral infections that cause sore throat at some point in its cycle due to how the mechanism of the condition work throughout its duration.

  • Common Cold
  • Flu
  • Measles
  • Chickenpox
  • COVID-19
  • Croup

Bacterial Infections (Strep Throat)

Apart from viral infections that are so prevalent when it comes to the issue of sore throat, a particular bacterial infection nearly contests this prevalence with its high incidence, particularly among younger individuals such as teenagers and children. Strep Throat is a condition caused by a pathogen called Streptococcus pyogenes, a group A streptococcus that can cause manifestations within the throat akin to how a sore throat commonly manifests.

Allergies

An allergic reaction to pet dander, molds, dust, and pollens could cause an irritation within the pharyngeal and esophageal region – resulting in scratchiness and pain that is often described as a case of sore throat. This problem is commonly coupled with what is known as postnasal drip, wherein the drainage from your nose causes inflammation and further irritation of the throat.

Dryness

Dry air could usually cause a rough and scratchy feeling in your throat – leading to manifestation that is similar to a sore throat. This is more common among individuals with chronic nasal congestion, as breathing through the mouth tends to dry and irritate the throat.

Irritants

Behaving similarly to allergens, irritants such as tobacco smoke or chemicals may cause inflammation and irritation, resulting in chronic sore throat upon repetitive exposure to the substance. This case likewise applies to chewing tobacco, drinking alcohol, and eating highly spicy foods.

Gastroesophageal Reflux Disease (GERD)

GERD is a digestive disorder wherein stomach acid overproduces, resulting in the backflow of digestive liquids towards the esophagus. While these are not particularly new as they are necessary for food digestion, the excessive backflow of acid irritates the oropharyngeal area, causing other symptoms such as heartburn, hoarseness, and a sensation of a lump in your throat.

Tumor or Cancer

While rare, cancerous tumors of the throat, tongue, or larynx may manifest as a sore throat in its initial stages. This is usually coupled with hoarseness, difficulty in swallowing, noisy breathing, a lump in the neck, and the presence of blood in your saliva or phlegm.

Sexually Transmitted Conditions that May Manifest Sore Throat

To determine whether a particular sexually transmitted condition precipitates your manifestations, the following list is the STDs/STIs that are often observed with sore throat along with other telltale features that you can use to employ immediate prophylactic and diagnostic measures.

Chlamydia

Symptomatic Presentations

Chlamydia is a precipitated condition due to inoculation of the pathogen known as Chlamydia trachomatis, or otherwise known as C. trachomatis in its abbreviated form. Chlamydia is a sexually transmitted condition that is equally dominant in both men and women – presenting with symptoms akin to cervicitis, urethritis, and proctitis among infected individuals. It has shown specific overlapping signs with other conditions, but imperative treatment and management are necessary due to its tendency to progress into more severe conditions that have been previously found to cause irreversible damages.

It is commonly asymptomatic in most cases, but it has specific distinctive symptoms in men and women for symptomatic issues. For women, infected patients may experience mucopurulent discharge and easily induced endocervical bleeding, along with pyuria, dysuria, and urinary frequency. If it progresses into a condition known as a pelvic inflammatory disease, it may result in pelvic pain, cervical motion tenderness, and uterine tenderness.

For men, infected individuals often observe a mucoid or watery urethral discharge and dysuria, while those with a complication of epididymitis may experience unilateral testicular pain, tenderness, and swelling.

Diagnosis

The testing process of Chlamydia is relatively straightforward due to its general use of what could be considered a highly specific and sensitive diagnostic procedure known as a nucleic acid amplification test or NAAT. The test would generally require the collection of genital swabs or urine samples. In cases where the availability of the test is scarce, the use of cell culture techniques is also acceptable, given that the patient's manifestations do not warrant an imperative course of treatment (severity should be assessed and reflected in the choice of the test).

Treatment Regimen

Chlamydial infections are quickly addressed by either a 7-day course of antibiotics or a single-dose antibiotic designed to suppress the presence of the causative agent and prevent its further transmission. Do note, however, that abstinence is highly recommended during the treatment period as it is necessary first to assess the patient's safety before they partake in any sexual activity. Likewise, patients are encouraged to have their recent sexual partners tested to determine whether they would require a prophylactic course of treatment.

Gonorrhea

Symptomatic Presentations

Gonorrhea, a sexually transmitted condition that primarily attacks the mucous membranes of the genitalia, is a disease caused by the microorganism known as Neisseria gonorrhoeae or N. gonorrhoeae. Due to its rather extreme preference for mucous membranes, the condition is mainly observed in the reproductive tract, the cervix, uterus and could even infect something as far as the fallopian tubes. Furthermore, its infective state is not only observed in the genital area, as it can likewise be observed in the mouth, throat, and rectum.

Similar to how other STDs behave, gonorrhea is widely asymptomatic for most cases, but it does have a few unique presentations upon its progression. Males may present with dysuria and a white, yellow, or green urethral discharge that usually occurs following its 14-day incubation period. Of course, cases where the patient has developed epididymitis, would precipitate testicular or scrotal pain.

On the one hand, infected women would generally present with a mild vaginal infection such as dysuria, increased discharge, and vaginal bleeding in between menstrual periods.

Rectal infections, on the other, may include discharge, anal itching, soreness, bleeding, and painful bowel movements.

Diagnosis

The diagnostic procedure for gonorrhea employs a highly-sensitive test known as a nucleic acid amplification test or NAAT – requiring urine, urethral, vaginal, or endocervical swap samples to perform its analysis of the patient’s status. Culture testing may likewise be performed, but this is highly dependent on the preference of the physician, the urgency of the situation, and the availability of resources in the market.

Treatment Regimen

The following treatment regimen is the recommended therapy by the Centers for Disease Control and Prevention for the management of gonorrheal cases:

  • 500 mg IM Ceftriaxone Single Dose

Do note that a test-of-cure will be required 7 to 14 days following the administration of the treatment regimen to ensure that the pathogen has been eliminated from the patient’s system.

Syphilis

Symptomatic Presentations

Syphilis, a sexually transmitted condition caused by the pathogen Treponema pallidum or T. pallidum, is infamous for its various health sequelae if the disease is not immediately managed with the appropriate therapy. What makes it so deceiving is its alternating periods of latency and overlapping symptoms that make it extremely hard to discern its current progression, particularly in cases where one cannot recall their previous exposure to the condition. Its incubation period could vary on a case-to-case basis, but the duration of the disease is categorized into four different stages.

The primary stage is the point from the initial exposure where the first chancroid appears – manifesting as a firm, round, and painless sore that usually goes away on its own after a few days. The chancres first appear at the exposure area, and once it is not resolved, the condition will progress into the secondary stage. Here, mucous membrane lesions mark the beginning of the stage along with rough, red, o reddish-brown spots in the palms of your hands and the soles of your feet. It can likewise be accompanied by a presentation known as condyloma lata or large, raised, gray or white lesions, along with systemic manifestations such as fever, swollen lymph glands, sore throat, patchy hair loss, body aches, weight loss, and fatigue.

Once the condition has not been managed in the previous stages, it could then progress into a period of clinical latency where the pathogen continues to replicate but does not produce any evident manifestations. Failing to address the condition would then result in the progression to its tertiary stage – the issue where the disease can now affect multiple organ systems.

Diagnosis

Treponemal tests are commonly indicated for syphilitic cases as it has been found that the test can determine treponemal antibodies earlier and better than other tests can. However, one should likewise note that non-treponemal tests are also indicated for positive cases due to the tendency of treponemal tests to detect antibodies produced from a previous treponemal infection.

Treatment Regimen

The Centers for Disease Control and Prevention recommends the following treatment regimens for various stages of the condition:

  • Adults and adolescents with primary, secondary, or early latent syphilis: Benzathine Penicillin G 2.4 million units IM single dose
  • Adults and adolescents with late latent or latent syphilis of unknown duration: Benzathine Penicillin G 7.2 million units in total, administered in 3 doses of 2.4 million units each IM every week
  • Neurosyphilis, ocular syphilis, otosyphilis: Aqueous Crystalline Penicillin G 18-24 million units/day, administered as 3-4 million units IV every 4 hours or continuous infusion for 10-14 days.

Oral Herpes

Symptomatic Presentations

Herpes is a widely asymptomatic condition caused by two variations of a particular virus: herpes simplex virus types 1 and 2, or HSV-1 and HSV-2, respectively. The two variations of the virus may present similar symptoms, but their presentation area is commonly observed in two different locations. For instance, HSV-1 is widely known to cause oral herpes, characterized by cold sores and fever blisters on or around the mouth of an infected individual. On the one hand, HSV-2 is associated with genital herpes – a condition that presents with blisters that break and leave painful ulcers that usually take two to four weeks to heal.

Apart from the distinctive symptoms of the two variants, herpes may also present with systemic manifestations such as fever, body aches, swollen lymph nodes, and headaches. Prodromal symptoms are sometimes also evident before a herpes outbreak, such as localized genital pain and tingling or shooting pains in the legs, hips, or buttocks.

Diagnosis

The most sensitive and specific test that can be employed for herpes is a nucleic acid amplification test or NAAT due to how it can detect the presence of the virus better than other tests can. However, due to the fluctuating viral load of infected individuals due to the intermittent viral shedding of herpes outbreaks, there are instances of false-negative results with the use of this particular procedure.

Type-specific virologic tests are often employed for such instances because they can provide a diagnosis despite the recurrence of symptoms. HSV-1 serologic testing, on the other hand, is often disregarded for HSV-1 infections due to its inability to distinguish oral and genital manifestations.

Treatment Regimen

Currently, there are no indicated medications for treating herpes (both oral and genital). Still, suppressive antiviral medications may be administered to prevent the progression and transmission of the condition upon sexual contact.

Human Immunodeficiency Virus (HIV)

Symptomatic Presentations

HIV is a sexually transmitted condition caused by a pathogen similarly named (human immunodeficiency virus) to the disease – mainly attacking the immune system to the point where it becomes so damaged that a person becomes highly susceptible to opportunistic infections. The symptomatic manifestations of HIV greatly vary due to how the disease progresses differently depending on how the body responds to its attack. Still, it does present the following manifestations, particularly during its acute symptomatic phase:

  • Fever
  • Chills
  • Rashes
  • Night Sweats
  • Muscle Pain
  • Sore Throat
  • Fatigue
  • Enlarged Lymph Nodes
  • Mouth Ulcerations

The progression of the condition is further divided into three categories; namely, the acute stage where the viral load is high and some people may experience flu-like symptoms, the chronic phase where the condition becomes latent but the virus still replicates, and the stage where the disease finally turns into an Acquired Immunodeficiency Syndrome or AIDS – a severe phase where the CD4 count drops below 200 cells/mm.

Diagnosis

Three types of tests are used to determine whether a patient is positive for HIV:

  • Nucleic Acid Tests: involves looking for the presence of the virus in the blood and determining its viral load.
  • Antigen/Antibody Tests: determines the presence of both antigens and antibodies for HIV from a blood sample.
  • Antibody Tests: determines the presence of HIV antibodies in either your blood or oral fluid.

Treatment Regimen

There is no approved cure for HIV as it is a highly complicated virus that primarily targets the body’s immune system. However, antiretroviral therapies are often used consistently to suppress the virus to an undetectable level – preventing its proliferation and destruction of the body’s immune system while likewise making the host non-infectious even if they did partake in any sexual activity.

Human Papillomavirus (HPV)

Symptomatic Presentations

HPV is a sexually transmitted disease caused by a pathogen known as Human Papillomavirus or HPV. In most cases, HPV infections are resolved without any necessary treatments, but in cases where it does present a few symptomatic manifestations, the most commonly observed presentations are genital warts or a group of bumps within the affected area.

Diagnosis

There is no standard way of detecting an individual’s HPV status due to how it usually gets resolved on its own and due to its mainly asymptomatic presentation. In addition to that, there is likewise no recognized test to determine its manifestations in the mouth or throat. There is, however, a cervical cancer screening test that can be used to determine the presence of HPV, but it is not recommended for males, adolescents, or women under the age of 30 years.

Treatment Regimen

There is no standard treatment for HPV infections, but there are two ways by which one could manage the potential symptoms and complications that an HPV infection might entail:

  • Manage genital warts to prevent them from growing or multiplying
  • Pretreatment for potential cervical cancer cases as HPV is notorious for causing cervical cancers despite its initial “mild” presentation.

Available Testing Options for STD-Related Sore Throat

Considering that there might be cases wherein you might suspect that an underlying STD is causing your sore throat, the following testing options are potential options for laboratories that could provide you with the confirmation that you will be needing:

Laboratory

HPV

Chlamydia

Syphilis

Gonorrhea

HIV

Oral Herpes

Package Prices

What it Offers

STD Check Labs

No

Yes

Yes

Yes

Yes

Yes

Custom kit at $357

  • Does not include an HPV test
  • Obtain result in around 1 to 2 days
  • On-site sample collection and testing
  • Extremely versatile custom kit

myLAB Box

Yes

Yes

Yes

Yes

Yes

No

14-Panel STD Kit at $379.00

  • Obtain results in 2 to 5 days
  • No test for oral herpes
  • At-home sample collection kit
  • Relatively expensive due to restrictive packages

HealthLabs

No

Yes

Yes

Yes

Yes

Yes

Comprehensive STD Panel at $139

  • Obtain results in 1-3 days
  • HPV test is unavailable
  • Online orders and transaction
  • On-site sample collection and testing

GetTested (CDC)

Yes

Yes

Yes

Yes

Yes

Yes

Free to use

  • Publicly accessible database that can be used to find potential laboratories within your area for your desired tests

Frequently Asked Questions (FAQs)

Can latex condoms prevent HIV transmission?

Yes, if used correctly and appropriately during sexual intercourse.

Is HIV transmissible through oral sex?

Yes. The risk is not necessarily known, but it is possible due to the possibility of ingesting bodily fluids through this process.

Does getting a tattoo increase one’s risk of contracting HIV?

If the tattoo artist does not sterilize their needles and has previously handled an HIV-positive patient, you can be infected.

Can syphilis be cured entirely?

With the proper medications, yes. However, the damage to the structures of your reproductive system is already irreversible.

How long does the latent stage of syphilis usually last?

It varies on a case- to-case basis, but it could last for as long as decades.

Further Reading

WebMD

U.S. Department of Veterans Affairs

National Center for Biotechnology Information

References

Written by Mark Riegel, MD

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